Bumblebee is a one-year four-month-old Basset Hound that first presented to Fitzpatrick Referrals on 23rd December 2011. Bumblebee was born with a birth defect which meant that she had no foot on the left front leg. She had one toe rather than a full foot and had no pads to walk on. This is a condition called ectrodactyly and is illustrated in the radiograph opposite. Because Bumblebee is a Basset Hound with a very deep chest she was going to find it very difficult to manage on three legs as her other front leg is understandably short and stumpy and therefore she would tend to drag her chest along the ground. She also has a very heavy head, do as all Basset Hounds. Therefore the owner was considering euthanasia if a suitable treatment could not be found to try and save the left front leg.
The owner’s daughter, who is 34 years old, has a chromosomal abnormality which causes dementia. The only creature she will speak to is Bumblebee and her written communication to Santa for example has been to have a new foot for Bumblebee. Clearly there are highly emotive circumstances surrounding this case, which require appropriate tact and consideration.
A further physical problem became manifest over the next six months in that because Bumblebee did not use the left front leg properly there was muscle wastage and as a result the shoulder joint became deformed and loose. We would now need not only to replace the foot but also to replace the shoulder. This is a situation which was unprecedented and there were no known implants available to achieve this objective.
Clearly many animal owners and many vets are not aware that any of this technology is available so to many people this is a new horizon. It is also of note that the press commonly draws parallels between such medical progress and the possibility of application to humans. Similar devices are already being employed successfully in humans but this device is the first in the world made specifically for animals and therefore it is hoped that Bumblebee will act as a beacon for other animals, which may be able to receive this implant in the future. The holy grail of amputation prostheses is to develop a permanent attachment between the bone inside the skin and the foot outside the skin. Human amputees with prosthetics generally have suction cups which attach the prosthetic to the remaining stump of the leg. This is absolutely not the same as a skeletally anchored prosthesis where the device is physically attached to the bone and a special dome has been designed onto which the skin can grow as a permanent seal. This is just like the gum around one of your teeth forming a permanent seal against bacteria. Avoiding the use of a suction cup based prosthesis prevents the nasty stump based complications human amputees have to deal.
The shoulder replacement operation was performed on 11th October 2012 and involved making a new joint surface for the shoulder blade within which the humerus or arm bone would move freely but without dislocating. This proved successful. On 11th January 2013 the device to replace Bumblebee’s left foot was placed. The metal inside the skin is called an endoprosthesis and the foot outside is called an exoprosthesis. We have been developing several different kinds of exoprostheses over the last several years to try and optimise the gait pattern of an individual dog and make it as normal as possible. So far Bumblebee’s operation has been a success. The skin has healed well around the peg and she is running very well on her first generation foot.
We kept Bumblebee at Fitzpatrick Referrals throughout the recovery period as it was deemed to be too traumatic for the owner’s daughter to have to deal with Bumblebee during recovery, so, whilst the owner and other family friends have visited, this week was the first time that the owner’s daughter saw Bumblebee for several months. This reunion was profoundly emotional and touching.
